Oral Ketamine/Midazolam Is Superior to Intramuscular Meperidine, Promethazine, and Chlorpromazine for Pediatric Cardiac Catheterization

Abstract

Oral medication can be superior to IM injections for sedating children with congenital heart disease; however, the safety of all medications remains an issue.

Cardiac Catheterization Laboratory: Catheterization, Interventional Cardiology, and Ablation Techniques for Children

“…It can be used intramuscular (IM) in a dose of 3 to 8 mg/kg 6 IV with a bolus of 1 mg/kg, followed by a continuous infusion of 50 to 70 mcg/kg/min 7 or orally with or without midazolam in a dose of 10 mg/kg. 8 Ketamine should be combined with an antisialagogue to prevent hypersalivation and airway irritability. Glycopyrrolate 0.005 mg/kg IM or IV should be added.…”

Anaesthesia for children with congenital heart disease undergoing diagnostic and interventional procedures

“…Nevertheless, even in these centres, some procedures are performed in the presence of anaesthesiologists, and the question always remains how the decision to proceed with or without an anaesthesiologist is taken. Although, in close collaboration with anaesthesia services, an algorithm to administer sedation in a catheterization laboratory can be developed, there will still be the need for skilled personnel in the case of an emergency [23][24][25]. More importantly, the concept of conscious sedation in young children could be synonymous with unmonitored general anaesthesia.…”

Anesthesia for Noncardiac Surgery in Children with Congenital Heart Disease

“…Qp:Qs decreased in patients with cardiac shunt, which lead to further desaturation in patients with cyanotic heart disease (Qp:Qs < 1).31 In another study on pediatric patients undergoing elective catheterization, it was shown that propofol anesthesia is a practical alternative to ketamine because of the significantly shorter recovery time. 30 Narcotic Anesthesia…”